=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548646920
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STAR TRANSIT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2015
-----------------------------------------------------
Last Update Date | 08/07/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 S VIRGINIA ST
-----------------------------------------------------
City | TERRELL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75160-3716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-563-1422
-----------------------------------------------------
Fax | 972-563-1491
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 703
-----------------------------------------------------
City | TERRELL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75160-0013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-563-1422
-----------------------------------------------------
Fax | 972-563-1491
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. OMEGA ANN HAWKINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 469-474-2301
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 347B00000X
-----------------------------------------------------
Taxonomy Name | Bus
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------